title: Smoking and prostate cancer in a multi-ethnic cohort.
abstract: BACKGROUND
  Prostate cancer (PCa) and smoking-related morbidity disproportionately burdens African American (AA) men. Smoking is associated with high-grade PCa and incidence, but few studies have focused on AA men. This study aims to determine the effect of tobacco-use on odds of PCa and of high-grade PCa in a population of predominantly AA men.
  
  
  METHODS
  This is a cross-sectional study evaluating smoking and PCa status in men with incident PCa and screened healthy controls. Altogether, 1,085 men (527 cases and 558 controls), age ≥ 40 years were enrolled through outpatient urology clinics in two US cities from 2001 to 2012. Validated questionnaires were used to gather clinical and socioeconomic data.
  
  
  RESULTS
  The cases and controls were predominantly AA (79.9% and 71.3%, respectively, P = 0.01). AA men smoked more frequently (53.4% vs. 47.9%, P < 0.001) and quit less frequently than European American (EA) men (31.5% vs. 40.4%, P = 0.01). AA heavy smokers had increased odds of PCa diagnosis (OR 2.57, 95% CI 1.09, 6.10) and high-grade cancer (OR 1.89, 95% CI 1.03, 3.48) relative to never smokers and light smokers. Among AAs, heavy smokers had lower odds of NCCN low PCa recurrence risk stratification. AA former smokers had a trend for increased odds of high-grade cancer compared to never smokers. The associations between smokings, cancer diagnosis and cancer grade did not reach statistical significance in EA men.
  
  
  CONCLUSIONS
  We found ethnic differences in smoking behavior. Heavy smoking is associated with increased odds of PCa and of higher Gleason grade in AA men.
authors.affiliation: Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. a-murphy2@md.northwestern.edu
authors.forename: Adam B
authors.initials: AB
authors.lastname: Murphy
authors.forename: Folasade
authors.initials: F
authors.lastname: Akereyeni
authors.forename: Yaw A
authors.initials: YA
authors.lastname: Nyame
authors.forename: Mignonne C
authors.initials: MC
authors.lastname: Guy
authors.forename: Iman K
authors.initials: IK
authors.lastname: Martin
authors.forename: Courtney M P
authors.initials: CM
authors.lastname: Hollowell
authors.forename: Kelly
authors.initials: K
authors.lastname: Walker
authors.forename: Rick A
authors.initials: RA
authors.lastname: Kittles
authors.forename: Chiledum
authors.initials: C
authors.lastname: Ahaghotu
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D000368:Aged; D003430:Cross-Sectional Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D016017:Odds Ratio; D017430:Prostate-Specific Antigen / Q000032:analysis*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology; D014481:United States; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D017430:Prostate-Specific Antigen
keywords: African American; cancer disparities; prostate cancer; smoking